ADVANCED DIAGNOSTIC LABS LLC (NPI# 1730572074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730572074 |
| Entity Type | Organization |
| Organization Name | ADVANCED DIAGNOSTIC LABS LLC |
| Practice Address |
3330 N 2nd St Suite 200 Phoenix AZ 85012-2368 |
| Mailing Address |
Po Box 36395 Phoenix AZ 85067-6395 |
| Practice Telephone | 6028899880 |
| Practice Fax Number | 4803049328 |
| Mailing Telephone | 6028899880 |
| Mailing Fax Number | 4803049328 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | LAAVAYNA RAJU (OWNER) |
| Authorized Official Telephone | 6028899880 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
3330 N 2ND ST SUITE 200 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-2368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205832706 | Stephen Henry Ponas | Urology | 3330 N 2nd St, Ste 601, Phoenix, AZ 85012-2368 | 2005-06-21 |
| 1528435252 | Mylene Ray Plado | Nurse Practitioner | 3330 N 2nd St, Suite 300, Phoenix, AZ 85012-2368 | 2015-08-28 |
| 1043608318 | Srp Facility Pllc | Clinic/Center | 3330 N 2nd St, Suite 200, Phoenix, AZ 85012-2368 | 2015-01-08 |
| 1588068266 | John C Lincoln, LLC | Family Medicine | 3330 N 2nd St, Suite 500, Phoenix, AZ 85012-2368 | 2014-10-09 |
| 1851723449 | Akdhc, LLC | Internal Medicine | 3330 N 2nd St, Suite 206, Phoenix, AZ 85012-2368 | 2013-08-06 |
| 1790123834 | Sean Allan Marco | Internal Medicine | 3330 N 2nd St, Ste 300, Phoenix, AZ 85012-2369 | 2013-06-11 |
| 1184909707 | Favour Enterprises L.l.c | Pharmacy | 3330 N 2nd St, Phoenix, AZ 85012-2368 | 2011-10-14 |
| 1801189519 | Srp Facility | Clinic/Center | 3330 N 2nd St, Suite 200, Phoenix, AZ 85012-2368 | 2011-05-27 |
| 1639461601 | Abbigail Lynn Tittle | Nurse Practitioner | 3330 N 2nd St, Suite 300, Phoenix, AZ 85012-2368 | 2011-05-10 |
| 1629371414 | Sanjay R Patel Md Pllc | Physical Medicine & Rehabilitation | 3330 N 2nd St, Suite 200, Phoenix, AZ 85012-2368 | 2010-12-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1417429077 | Tela Ventures, LLC | Clinical Medical Laboratory | 3608 N 56th St, Phoenix, AZ 85018-4536 | 2018-12-20 |
| 1154809937 | Volentedx Scottsdale, LLC | Clinical Medical Laboratory | 4530 E Shea Blvd Ste 165, Phoenix, AZ 85028-6042 | 2018-08-02 |
| 1376038950 | Dbw Diagnostics, LLC | Clinical Medical Laboratory | 2414 W Sierra St, Phoenix, AZ 85029-3425 | 2018-06-26 |
| 1558851519 | Prorenata Labs LLC | Clinical Medical Laboratory | 8222 S 48th St Ste 210, Phoenix, AZ 85044-5303 | 2018-05-15 |
| 1528561362 | Beacon Biomedical Inc. | Clinical Medical Laboratory | 275 N Gateway Dr Ste 149, Phoenix, AZ 85034-1700 | 2018-03-16 |
| 1518473263 | Cutaneous Neurodiagnostics, LLC | Clinical Medical Laboratory | 5070 N 40th St Ste 125, Phoenix, AZ 85018-2193 | 2017-12-18 |
| 1174044127 | Daniel Fernandez Hernandez | Clinical Medical Laboratory | 5323 W Odeum Ln, Phoenix, AZ 85043-6595 | 2017-06-29 |
| 1104346386 | Greysky Diagnostics LLC | Clinical Medical Laboratory | 906 W Roosevelt St Ste 2, Phoenix, AZ 85007-2106 | 2017-06-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.